TREATMENT OUTCOMES OF FIRST-LINE XELOX CHEMOTHERAPY IN PATIENTS WITH STAGE IV GASTRIC CANCER AT 108 MILITARY CENTRAL HOSPITAL
Main Article Content
Abstract
Objective: To evaluate the treatment response and toxicity of first-line XELOX chemotherapy in patients with stage IV gastric cancer at 108 Military Central Hospital.
Subjects and Methods: A descriptive cross-sectional study combining retrospective and prospective data collection with longitudinal follow-up was conducted in 38 patients with stage IV gastric adenocarcinoma. Patients received the XELOX regimen consisting of oxaliplatin 130 mg/m² on day 1 and capecitabine 1000 mg/m² twice daily on days 1–14, repeated every 21 days for a maximum of 8 cycles. Adverse events were assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0, and tumor response was evaluated after every 3 cycles according to RECIST version 1.1.
Results: The overall response rate was 52.6%, including 7.9% complete response and 44.7% partial response; 15.8% of patients had stable disease and 31.6% had progressive disease. Following treatment, clinical symptoms and performance status improved significantly (p < 0.05). The response rate was significantly higher in patients receiving the standard dose than in those receiving a reduced dose (72.2% vs. 40.0%; p < 0.05).
Conclusion: The XELOX regimen is an effective first-line treatment option for patients with stage IV gastric cancer, providing improvement in clinical symptoms and performance status. Maintaining the standard dose may enhance treatment response. Overall, the regimen demonstrated an acceptable safety profile and good tolerability in clinical practice.
Keywords
Advanced gastric cancer, XELOX, chemotherapy response
Article Details
References
2. Trần Minh Phương, Đỗ Anh Tú. Đánh giá kết quả điều trị bước đầu bệnh nhân ung thư dạ dày giai đoạn muộn bằng phác đồ XELOX tại Bệnh viện K. Tạp chí Y học Việt Nam. 2024;538(1). doi:10.51298/vmj.v538i1.9307
3. Nguyễn Khánh Toàn. Đánh giá kết quả của phác đồ XELOX trong điều trị ung thư dạ dày giai đoạn muộn tại Bệnh viện K. Đại học Y Hà Nội; 2013.
4. Park YH, Lee JL, Ryoo BY, et al. Capecitabine in combination with Oxaliplatin (XELOX) as a first-line therapy for advanced gastric cancer. Cancer Chemother Pharmacol. 2008;61(4):623-629. doi:10.1007/s00280-007-0515-7
5. Park YH, Kim BS, Ryoo BY, Yang SH. A phase II study of capecitabine plus 3-weekly oxaliplatin as first-line therapy for patients with advanced gastric cancer. Br J Cancer. 2006;94(7):959-963. doi:10.1038/sj.bjc.6603046
6. Van Cutsem E, Moiseyenko VM, Tjulandin S, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: A report of the V325 Study Group. J Clin Oncol. 2006;24(31):4991-4997. doi:10.1200/JCO.2006.06.8429
7. Zhu XD. XELOX doublet regimen versus EOX triplet regimen as first-line treatment for advanced gastric cancer: An open-labeled, multicenter, randomized, prospective phase III trial (EXELOX). Cancer Commun. 2022;42:314-326.
8. Jatoi A. Oxaliplatin and capecitabine in patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction and gastric cardia: a phase II study from the North Central Cancer Treatment Group. Ann Oncol. 2006;17:29-34.
9. Lee GJ. A Randomized Phase III Study of Patients With Advanced Gastric Adenocarcinoma Without Progression After Six Cycles of XELOX (Capecitabine Plus Oxaliplatin) Followed by Capecitabine Maintenance or Clinical Observation. J Gastric Cancer. 2023;23:315.